Author Identifier (ORCID)
Anna Maria Markarian: https://orcid.org/0000-0003-2863-1544
Dennis R. Taaffe: https://orcid.org/0000-0001-6381-1597
Daniel A. Galvão: https://orcid.org/0000-0002-8209-2281
Carolyn J. Peddle-McIntyre: https://orcid.org/0000-0001-9913-4022
Jodie Cochrane Wilkie: https://orcid.org/0000-0003-1234-9579
Francesco Bettariga: https://orcid.org/0000-0002-4977-5494
Robert Newton: https://orcid.org/0000-0003-0302-6129
Abstract
Skeletal muscle loss during chemotherapy has been associated with poorer outcomes and reduced survival across several types of cancer. However, the extent and progression of muscle loss during treatment for childhood cancers remain unclear. A better understanding could help identify children at increased risk and inform the timing of targeted intervention. This systematic review and meta-analysis aimed to synthesize the evidence on skeletal muscle changes during treatment for childhood cancers and identify factors that influence these outcomes. A systematic search was conducted in CINAHL, Embase, PubMed, SPORTDiscus, and Web of Science. Studies were eligible if they included children and adolescents (< 19 years) undergoing cancer treatment and reported muscle quantity at a minimum of two time points. The methodological quality of the included studies was evaluated using the Newcastle–Ottawa Scale. Twenty studies (n = 646; age range: 2.5–14.7 years) were included. A significant decline in muscle quantity was observed during the early phase of treatment (standardized mean difference (SMD): SMD = − 0.36; 95% CI: − 0.59 to − 0.13; p < 0.05). At later follow-up time points, the overall change was not statistically significant (SMD = − 0.08; 95% CI: − 0.27 to 0.10; p = 0.36). However, estimates of muscle quantity varied significantly by assessment modality (p = 0.048). Conclusion: Children with cancer experience significant skeletal muscle loss during the intensive phase of treatment. While decrements observed at later time points appear modest, reported outcomes vary considerably depending on the assessment method. Standardized, reliable body composition measures are needed to detect meaningful changes and guide clinical care. (Table presented.)
Document Type
Journal Article
Date of Publication
8-1-2025
Volume
184
Issue
8
PubMed ID
40742460
Publication Title
European Journal of Pediatrics
Publisher
Springer
School
Exercise Medicine Research Institute / School of Medical and Health Sciences
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
Markarian, A. M., Taaffe, D. R., Galvão, D. A., Peddle-McIntyre, C. J., Wilkie, J. C., Bettariga, F., & Newton, R. U. (2025). Longitudinal changes in skeletal muscle in children undergoing cancer treatment: A systematic review and meta-analysis. European Journal of Pediatrics, 184. https://doi.org/10.1007/s00431-025-06349-5